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This is VAERS ID 158751

(NOTE: This result is from the 12/31/2003 version of the VAERS database)

Case Details

VAERS ID: 158751 (history)  
Form: Version .0  
Age: 0.8  
Sex: Male  
Location: Wisconsin  
Vaccinated:2000-07-27
Onset:2000-07-28
   Days after vaccination:1
Submitted: 2000-07-31
   Days after onset:3
Entered: 2000-08-15
   Days after submission:15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC: PREVNAR / LEDERLE 475228 / 1 LL / IM

Administered by: Private       Purchased by: Unknown
Symptoms: REACT UNEVAL
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2000-07-28
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Sinusitis
Preexisting Conditions: Walker-Warburg syndrome
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death. Doubt any relationship other than temporal.


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=158751


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